To explore the role of multidisciplinary team (MDT) in the diagnosis and treatment of patients with colorectal cancer.

A retrospective analysis of CRC patients who underwent MDT discussions from July 2010 to February 2019 at Zhongshan Hospital, Fudan University was conducted and analyzed.

A total of 4 535 MDT discussions developed individualized treatment regimens for 1 953 patients with CRC. Among them, 553 patients with liver metastases and 111 with lung metastases were considered to be resectable. Moreover, 261 patients with initially unresectable colorectal liver metastases were converted to resectable after receiving comprehensive treatment. Actually a total of 772 patients underwent hepatectomy, including 581 patients with synchronous liver metastases, and 248 patients received simultaneous resection of primary colorectal cancer and liver metastases. Only 87 patients (11.3%) underwent anatomical hepatectomy, while the vast majority performed non-anatomical hepatectomy. Sixty-two patients (8.0%) underwent hepatectomy combined with intraoperative radiofrequency ablation. Postoperative pathology results revealed 18 (2.3%) cases of R1 resection.

MDT discussion is recommended for patients with complex CRC. Expanding surgical indications, applying two-step hepatectomy, and combination with radiofrequency ablation can expand the population who underwent metastases surgery. For patients with initially unresectable metastases, it is recommended to perform strong individualized conversion therapy for secondary surgical resection if fit.